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Dadras O. Predictor of smoking cessation among school-going adolescents in Indonesia: a secondary analysis based on the transtheoretical model of behavioral change. Front Psychiatry 2024; 15:1374731. [PMID: 38516262 PMCID: PMC10954880 DOI: 10.3389/fpsyt.2024.1374731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 02/22/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction This study elucidates the complex journey of adolescents toward smoking cessation, investigating the association of relevant demographic factors, advertising, promotion, anti-cigarette messages, and individual knowledge and attitudes with being in different smoking cessation stages. Methods Utilizing data from the 2019 Indonesia Global Youth Tobacco Survey, this secondary analysis included adolescents who reported ever smoking. The Transtheoretical Model (TTM) guided the categorization of the outcome variable into three smoking cessation stages based on the responses to two questions related to the intention and timing of the smoking cessation. This included contemplation, action, and maintenance stages. Multinomial logistic regression analyzed the associations between each independent variable and being in each stage of smoking cessation. The study comprised 3596 Indonesian adolescents from grades 7-12, of which 2484 responded to two questions related to intention and timing of smoking cessation and were included in regression analysis. Results Findings indicate that males and those aged ≥16 were predominantly in contemplation phase. Early smoking initiation, usage of other tobacco products, and exposure to various forms of smoke increased the likelihood of being in contemplation and action phases. Parental smoking, school smoking exposure, and second-hand smoke were significant contemplation phase predictors. Exposure to tobacco advertising was linked to an increased likelihood of being in contemplation and action phases, whereas anti-cigarette messages showed no significant impact. Awareness of cigarette and second-hand smoke harms reduced the odds of being in the contemplation phase, while enjoying smoking and willingness to accept cigarettes from friends increased the odds of being in contemplation and action phases rather than in maintenance phase. Conclusion Addressing age, gender, cultural influences, environmental factors, and attitudes towards smoking through tailored interventions is vital for aiding smoking cessation in Indonesian adolescents. Strengthened tobacco control in schools and public places is recommended to bolster these efforts. Longitudinal studies are required to explore the evolving patterns of smoking cessation behaviors over time, enhancing our understanding of the factors influencing sustained cessation.
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Affiliation(s)
- Omid Dadras
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
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Alves J, Perelman J, Ramos E, Kunst AE. Intergenerational transmission of parental smoking: when are offspring most vulnerable? Eur J Public Health 2022; 32:741-746. [PMID: 35712820 PMCID: PMC9527976 DOI: 10.1093/eurpub/ckac065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previous literature has showed that the likelihood of smoking is higher among offspring with smoking parents. The aim of this cohort study is to investigate during which smoking initiation stages and at what ages adolescents are more likely to be influenced by parental smoking. METHODS This study used the EPITeen Cohort, which recruited 13-year-old adolescents born in 1990, enrolled at schools in Porto, Portugal. Participants (n = 996) were followed across four waves at 13, 17, 21 and 24 years old. We computed the odds ratio (OR) and 95% confidence intervals for the prevalence of the different smoking states (never smoking, experimenter, less than daily smoker, daily smoker and former smoker), and incidence transitions between these states (to smoking experimenter; to less than daily smoker, to daily smoker; to former smoker) as function of age, parental smoking status and their interaction. RESULTS Compared with other participants, those with two smoking parents had an increased prevalence of experimentation at 13 years (OR for the interaction at 13 years compared with 24 years = 2.13 [1.50-3.01]) and daily smoking at all ages (OR for parental smoking =1.91 [1.52-2.40]). The latter increase is related to a significantly increased risk to transit from early smoking stages to daily smoking at all ages (OR for parental smoking = 1.83 [1.43-2.34]). CONCLUSIONS Parental smoking influences offspring's daily smoking prevalence especially by increasing the risk to transit to daily smoking up to early adulthood. Prevention should focus on parents and parental influences especially among offspring who may transition to daily smokers.
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Affiliation(s)
- J Alves
- NOVA National School of Public Health, Public Health Research Centre, CISP, NOVA University Lisbon, Lisbon, Portugal.,NOVA National School of Public Health, Comprehensive Health Research Centre, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - J Perelman
- NOVA National School of Public Health, Public Health Research Centre, CISP, NOVA University Lisbon, Lisbon, Portugal.,NOVA National School of Public Health, Comprehensive Health Research Centre, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - E Ramos
- Faculty of Medicine, Department of Public Health and Forensic Sciences, and Medical Education, University of Porto, Porto, Portugal.,EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - A E Kunst
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Liang YC, Liao JY, Lee CTC, Liu CM. Influence of Personal, Environmental, and Community Factors on Cigarette Smoking in Adolescents: A Population-Based Study from Taiwan. Healthcare (Basel) 2022; 10:healthcare10030534. [PMID: 35327011 PMCID: PMC8951170 DOI: 10.3390/healthcare10030534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/28/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Abstract
Understanding the factors that influence cigarette smoking among adolescents is critical. We identified personal, community, and environmental factors associated with current cigarette smoking among adolescents. This population-based cross-sectional analysis study was conducted using the 2012 Taiwan Global Youth Tobacco Survey and the sociodemographic statistics of the city or county from Taiwan’s Ministry of the Interior. A total of 27,524 participants (age: 12–18-years) was included. The associated factors were identified through logistic regression. A path analysis was performed to examine the pathway from the associated factors to current cigarette smoking. According to this analysis, the following factors were prominently and positively associated with adolescent cigarette smoking: one personal factor (pocket money), five environmental factors (home secondhand smoke (SHS) exposure, smoker friends, outside SHS exposure, school SHS exposure, and smoker parents), and two community factors (free cigarettes from tobacco companies and indigenous population). By contrast, five personal factors (feeling less comfortable smoking at social occasions, feeling indifferent about smoking or not smoking at social occasions, female sex, feeling that quitting is difficult, and feeling that quitting after having smoked is harmful to health) and one environmental factor (school antismoking education) had negative effects. Thus, comprehensive interventions promoting the perception of harm caused by smoking and interrupting access to cigarettes through social networks can reduce cigarette smoking in adolescents.
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Affiliation(s)
- Yu-Chun Liang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei 10610, Taiwan; (Y.-C.L.); (C.T.-C.L.)
| | - Jung-Yu Liao
- Department of Public Health, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan;
| | - Charles Tzu-Chi Lee
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei 10610, Taiwan; (Y.-C.L.); (C.T.-C.L.)
| | - Chin-Mei Liu
- Taiwan Centers for Disease Control, Taipei City 10050, Taiwan
- Correspondence:
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Hayrumyan V, Harutyunyan A, Torosyan A, Grigoryan L, Sargsyan Z, Bazarchyan A, Petrosyan V, Dekanosidze A, Sturua L, Kegler MC, Berg CJ. Tobacco-related risk perceptions, social influences and public smoke-free policies in relation to smoke-free home restrictions: findings from a baseline cross-sectional survey of Armenian and Georgian adults in a community randomised trial. BMJ Open 2022; 12:e055396. [PMID: 35131832 PMCID: PMC8823221 DOI: 10.1136/bmjopen-2021-055396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 01/19/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Given high prevalence of smoking and secondhand smoke exposure in Armenia and Georgia and quicker implementation of tobacco legislation in Georgia versus Armenia, we examined correlates of having no/partial versus complete smoke-free home (SFH) restrictions across countries, particularly smoking characteristics, risk perceptions, social influences and public smoking restrictions. DESIGN Cross-sectional survey study design. SETTING 28 communities in Armenia and Georgia surveyed in 2018. PARTICIPANTS 1456 adults ages 18-64 in Armenia (n=705) and Georgia (n=751). MEASUREMENTS We used binary logistic regression to examine aforementioned correlates of no/partial versus complete SFH among non-smokers and smokers in Armenia and Georgia, respectively. RESULTS Participants were an average age of 43.35, 60.5% women and 27.3% smokers. In Armenia, among non-smokers, having no/partial SFHs correlated with being men (OR=2.63, p=0.001) and having more friend smokers (OR=1.23, p=0.002); among smokers, having no/partial SFHs correlated with being unmarried (OR=10.00, p=0.001), lower quitting importance (OR=0.82, p=0.010) and less favourable smoking attitudes among friends/family/public (OR=0.48, p=0.034). In Georgia, among non-smokers, having no/partial SFHs correlated with older age (OR=1.04, p=0.002), being men (OR=5.56, p<0.001), lower SHS risk perception (OR=0.43, p<0.001), more friend smokers (OR=1.49, p=0.002) and fewer workplace (indoor) restrictions (OR=0.51, p=0.026); among smokers, having no/partial SFHs correlated with being men (OR=50.00, p<0.001), without children (OR=5.88, p<0.001), daily smoking (OR=4.30, p=0.050), lower quitting confidence (OR=0.81, p=0.004), more friend smokers (OR=1.62, p=0.038) and fewer community restrictions (OR=0.68, p=0.026). CONCLUSIONS Private settings continue to lack smoking restrictions in Armenia and Georgia. Findings highlight the importance of social influences and comprehensive tobacco legislation, particularly smoke-free policies, in changing household smoking restrictions and behaviours. TRIAL REGISTRATION NUMBER NCT03447912.
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Affiliation(s)
- Varduhi Hayrumyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Arusyak Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Arevik Torosyan
- MOH National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Lilit Grigoryan
- MOH National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Zhanna Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Alexander Bazarchyan
- MOH National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Ana Dekanosidze
- Non-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Lela Sturua
- Non-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Michelle C Kegler
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | - Carla J Berg
- Department of Prevention and Community Health, George Washington University, Washington, District of Columbia, USA
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Mpousiou D, Soteriades ES, Patrinos S, Sakkas N, Karakatsani A, Karathanasi A, Gratziou C, Katsaounou PA. Could adolescents be the vehicle that transfers a no-smoking rule from school to home? Tob Prev Cessat 2021; 7:52. [PMID: 34307967 PMCID: PMC8283973 DOI: 10.18332/tpc/137482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Banning smoking at home, schools, children's playgrounds and indoor environments, constitutes an integral part of tobacco control efforts to prevent uptake of smoking among young teenagers. We aimed at exploring the role of teenagers as facilitators of change in enforcing a home no-smoking rule following school-based anti-tobacco programs and examining the effect of home no-smoking rule on teenagers' intention to smoke. METHODS A school-based intervention-control study was implemented during the 2016-2017 academic year among middle-school students in Athens, Greece. The experiential learning intervention was delivered using an interdisciplinary approach, bridging excerpts from ancient classical Greek myths and ancient classical literature, with their decoded archetypal symbols applied in a smoking and tobacco control paradigm. An anonymous selfadministered questionnaire was used at baseline, and at follow-up at 3 months to evaluate program effectiveness. A chi-squared test was used for categorical variables and a t-test for continuous variables. Cohen's distance (d) was employed to examine the intervention effect size. A two-tailed p≤0.05 was considered statistically significant using IBM SPSS V.22. RESULTS In all, 351 students participated. At baseline, 47.5% in the intervention group reported a home no-smoking rule and 86% indicated being unlikely to smoke, these increased to 61.3% (p=0.016) and 98.2% (p<0.001) at followup, respectively. Cohen's d value was calculated to estimate the effect size of intervention. A large effect size of intervention was found in the intervention group (d=1.24), whilst d=0.19 in the control group. CONCLUSIONS Our study showed that our intervention led to the increase of no-smoking rules at home and to a negative intention towards smoking of adolescents. Consequently, we provide evidence that students are effective vehicles for carrying anti-smoking messages to their home environment including the no-smoking rule. Additionally, we confirmed previous reports that home no-smoking rule is associated with a negative intention to smoke and risk of smoking.
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Affiliation(s)
- Dimitra Mpousiou
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Thoracic Society, Athens, Greece
| | - Elpidoforos S. Soteriades
- Hellenic Thoracic Society, Athens, Greece
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, United States
| | | | - Nickolaos Sakkas
- Department of Physiotherapy, School of Bioscience, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Anna Karakatsani
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Thoracic Society, Athens, Greece
- 2nd Pulmonary Medicine Department, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Areti Karathanasi
- Institute of Educational Policy, Ministry of Education and Religious Affairs, Athens, Greece
| | - Chrstina Gratziou
- Evgenidion Clinic Agia Trias S. A., National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi A. Katsaounou
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Thoracic Society, Athens, Greece
- First Intensive Care Unit, Department of Pulmonary Medicine, Evaggelismos General Hospital, Athens, Greece
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Malhab SB, Hajj A, Lteif FHM, Salameh P, Khabbaz LR. Influence of genetic polymorphisms on waterpipe smoking phenotypes. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wu TS, Chaffee BW. Parental Awareness of Youth Tobacco Use and the Role of Household Tobacco Rules in Use Prevention. Pediatrics 2020; 146:peds.2019-4034. [PMID: 33020248 PMCID: PMC7642113 DOI: 10.1542/peds.2019-4034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Noncigarette tobacco use is increasing. In this study, we reexamined (1) parental knowledge or suspicion of their children's tobacco use and (2) associations of household tobacco-free rules with youth initiation. METHODS Participants were youth (aged 12-17) in waves 1 to 4 (2013-2018) of the Population Assessment of Tobacco and Health Study. A pseudo cross-sectional time-series analysis (N = 23 170) was used to examine parent or guardian knowledge or suspicion of their child's tobacco use according to youth-reported use categories: cigarette only, electronic cigarette only, smokeless tobacco only, noncigarette combustible only, and poly use. A longitudinal analysis among wave 1 never users (n = 8994) was used to examine rules barring tobacco inside the home and whether parents talked with youth about not using tobacco as predictors of youth tobacco initiation after 1 to 3 years. Survey-weighted multivariable models were adjusted for tobacco use risk factors. RESULTS In all waves, parents or guardians much less often knew or suspected that their children used tobacco if youth only reported use of electronic cigarettes, noncigarette combustible products, or smokeless tobacco compared with cigarettes. Youth tobacco initiation was lower when youth and parents agreed that rules prohibited all tobacco use throughout the home (1-year adjusted odds ratio: 0.74; 95% confidence interval: 0.59-0.94) but not when parents talked with youth about tobacco (adjusted odds ratio: 1.08; 95% confidence interval: 0.94-1.23). CONCLUSIONS Many parents are unaware of their children's noncigarette tobacco use. Setting expectations for tobacco-free environments appears more effective at preventing youth tobacco initiation than parents advising children not to use tobacco.
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Affiliation(s)
- Tsu-Shuan Wu
- University of California, San Francisco, San Francisco, California
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Jankowski M, Pinkas J, Zgliczyński WS, Kaleta D, Wierzba W, Gujski M, Rees VW. Voluntary Smoke-Free Home Rules and Exposure to Secondhand Smoke in Poland: A National Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7502. [PMID: 33076351 PMCID: PMC7602554 DOI: 10.3390/ijerph17207502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 11/18/2022]
Abstract
Smoke-free policies have been shown to significantly reduce secondhand smoke (SHS) exposure in private and public places. The objectives of this study were to: (1) to assess the prevalence and characteristics of voluntary smoke-free home rules in Poland; and (2) assess the association of smoke-free rules with self-reported SHS exposure in private homes. A cross-sectional survey was conducted in September 2019 with a nationally representative sample of 1011 individuals aged 15 and over. Nationally, 66.1% of individuals had a 100% smoke-free home rule (78.9% of non-smokers and 18.6% of smokers; p < 0.001), while a further 24.6% had adopted a partial home smoking rule. SHS exposure in the home during past month was reported by 6.1% of respondents (11.5% of smokers and 4.5% of non-smokers; p < 0.001). The lowest level of SHS exposure (1.8%) was observed among respondents who had implemented a full smoke-free home rule. Non-smokers had higher odds of having adopted a total smoke-free home rule compared with smokers (aOR: 19.17; 95% CI: 12.89-28.50). Moreover, non-smokers had lower odds (aOR: 0.35; 95% CI: 0.20-0.61; p < 0.001) of self-reporting SHS smoke exposure at home. Although two-thirds of the Polish population have adopted a full smoke-free home rule in their homes, smokers continue to lag in adoption rates relative to non-smokers.
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Affiliation(s)
- Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland; (M.J.); (J.P.); (W.S.Z.)
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland; (M.J.); (J.P.); (W.S.Z.)
| | - Wojciech S. Zgliczyński
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland; (M.J.); (J.P.); (W.S.Z.)
| | - Dorota Kaleta
- Department of Hygiene and Epidemiology, Medical University of Lodz, 90-647 Łódź, Poland;
| | - Waldemar Wierzba
- UHE Satellite Campus in Warsaw, University of Humanities and Economics in Łódź, 01-513 Warsaw, Poland;
| | - Mariusz Gujski
- Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Vaughan W. Rees
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Tackett AP, Keller-Hamilton B, Smith CE, Hébert ET, Metcalf JP, Queimado L, Stevens EM, Wallace SW, McQuaid EL, Wagener TL. Evaluation of Respiratory Symptoms Among Youth e-Cigarette Users. JAMA Netw Open 2020; 3:e2020671. [PMID: 33048131 PMCID: PMC8094411 DOI: 10.1001/jamanetworkopen.2020.20671] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Use of e-cigarettes (ECs) among youths has increased in recent years. e-Cigarette aerosol contains chemical constituents, such as diacetyl or benzaldehyde, which are known to affect the respiratory system. OBJECTIVE To examine the association between EC use and self-reported wheezing in a cohort of US adolescents. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from waves 3 and 4 (October 19, 2015, to January 3, 2018) of the Population Assessment of Tobacco and Health (PATH) study, a longitudinal, nationally representative cohort survey. Adolescent respondents aged 12 to 17 years who did not have asthma were included. EXPOSURES e-Cigarette use during the previous year. MAIN OUTCOMES AND MEASURES Self-reported wheezing in the past 12 months (yes or no) and EC use (no use in past year or never use, use in past year, use in past 30 days, and use in past 7 days). Survey-weighted logistic regression models adjusted for demographic characteristics and other risk factors. RESULTS Among 7049 adolescents without asthma from waves 3 and 4 of the PATH study, 49.9% were female and 54.4% were non-Hispanic White. In unadjusted models, the odds of wheezing in the past 12 months were higher for youths who had used ECs in the past year compared with those who had not (odds ratio, 1.74; 95% CI, 1.22-2.48; P = .003). In the adjusted model, after controlling for the variables of race/ethnicity, household rules about the use of tobacco, contact with a smoker in the previous 7 days, and current use of combustible tobacco products, the association of EC use with wheezing was not significant (adjusted odds ratio for EC use in the past year, 1.37 [95% CI, 0.91-2.05]; in the past 30 days, 1.35 [95% CI, 0.63-2.88]; in the past 7 days, 0.74 [95% CI, 0.28-1.97]; P = .33). CONCLUSIONS AND RELEVANCE In this cohort study, use of ECs alone was not associated with increased odds of experiencing wheezing episodes. Future studies incorporating the use of objective data appear to be needed to more accurately understand the potential respiratory harms associated with vaping among adolescents.
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Affiliation(s)
- Alayna P. Tackett
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | | | | | - Emily T. Hébert
- School of Public Health, The University of Texas Health Science Center, Austin
| | - Jordan P. Metcalf
- Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Lurdes Queimado
- Department of Otorhinolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Elise M. Stevens
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Elizabeth L. McQuaid
- Bradley/Hasbro Children’s Research Center, Providence, Rhode Island
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
- Department of Internal Medicine, The Ohio State University, Columbus
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Booalayan H, Abdualrasool M, Al-Shanfari S, Boujarwa A, Al-Mukaimi A, Alkandery O, Akhtar S. Exposure to environmental tobacco smoke and prevalence of asthma among adolescents in a middle eastern country. BMC Public Health 2020; 20:1210. [PMID: 32770990 PMCID: PMC7414674 DOI: 10.1186/s12889-020-09245-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 07/12/2020] [Indexed: 02/01/2023] Open
Abstract
Background There is increasing evidence linking environmental tobacco smoke (ETS) exposure at homes to the development of asthma among adolescents. Few studies have addressed this issue in the Middle Eastern countries including Kuwait. Therefore, this cross-sectional study assessed the prevalence of ETS exposure at home, prevalence of asthma and other respiratory conditions and examined the ETS exposure at home and personal tobacco smoking as risk factors for self-reported asthma among high-school students in Kuwait. Methods In this cross-sectional study, we enrolled participants from nine high-schools of Hawally Governorate of Kuwait during October 2015. We adapted a previously validated self-administered questionnaire for data collection. Prevalence of self-reported asthma and ETS exposure (≥ 1 smoker at home vs. none) were computed. The association between exposures of interest and self-reported asthma status was examined using a multivariable log-binomial regression model. Results Of 800 enrolled participants, 746 (92.2%) consented and completed the questionnaire. The participants with mean (SD) age of 16.8 (0.68) years were predominantly Kuwaiti (74.8%) and female (50.1%). The prevalence of ETS exposure at home and personal current smoking was 54 and 12.4% respectively. Self-reported asthma prevalence was 20.5%. Furthermore, the prevalence of physician-diagnosed asthma, wheezing during the last 12 months and wheezing ‘ever’ was 16.4, 20.1 and 26.2%, respectively. Fitted multivariable log-binomial regression model revealed that compared with the non-asthmatic, participants with self-reported asthma tended to be current smokers (adjusted prevalence ratio (adjusted PR) = 1.82; 95% CI: 1.30–2.56; p = 0.001) or have had ETS exposure at home (adjusted PR = 1.64; 95% CI: 1.21–2.23; p = 0.002). Conclusions We recorded a high prevalence of ETS exposure at home, high prevalence of self-reported asthma and identified ETS exposure at home and being a current smoker as strong risk factors for self-reported asthma among adolescents. Voluntary household smoking bans may substantially minimize the ETS exposure among adolescents. Additionally, such restriction may inculcate an antismoking attitude and prevent smoking initiation among adolescents. Such efforts may bring about reduction in ETS exposure and associated asthma risk and other smoking-related morbidities in this and other similar settings.
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Affiliation(s)
- Hussain Booalayan
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Mosa Abdualrasool
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Saad Al-Shanfari
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Abdulwahab Boujarwa
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Abdullah Al-Mukaimi
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Omar Alkandery
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Saeed Akhtar
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait.
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Kamke K, Sabado-Liwag M, Rodriquez EJ, Pérez-Stable EJ, El-Toukhy S. Adolescent Smoking Susceptibility: Gender-Stratified Racial and Ethnic Differences, 1999-2018. Am J Prev Med 2020; 58:666-674. [PMID: 32201186 PMCID: PMC7219202 DOI: 10.1016/j.amepre.2019.11.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/18/2019] [Accepted: 11/19/2019] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Susceptibility, or openness to smoking, is a predictor of future smoking. This study examines within-gender racial/ethnic differences in smoking susceptibility over historical time (1999-2018) and developmental age (11-18 years). METHODS Data were obtained from 205,056 adolescent never smokers in 14 waves of the National Youth Tobacco Survey. Weighted time-varying effect models were used to estimate nonlinear trends in smoking susceptibility among minority (versus white) adolescents. Analyses were conducted in 2019. RESULTS Compared with whites, Latino/a adolescents were consistently more susceptible to smoking, whereas black and Asian adolescents fluctuated between being less and equally susceptible over time. American Indian, Alaska Native, Native Hawaiian, and Pacific Islander adolescents were more susceptible from 2014 to 2017, with differences being larger for girls. Susceptibility peaked at age 14 years. Compared with whites, Latino/a adolescents were more susceptible throughout adolescence. Black adolescents were more susceptible in early adolescence, whereas Asian adolescents were less or equally susceptible to smoking in early to mid-adolescence. American Indian, Alaska Native, Native Hawaiian, and Pacific Islander girls were more susceptible in early and mid-adolescence, but boys were more susceptible in early adolescence only. American Indian, Alaska Native, Native Hawaiian, and Pacific Islander girls were less susceptible than white girls aged 18 years. CONCLUSIONS Twenty-year racial/ethnic differences in smoking susceptibility were evident, particularly among girls, but were mostly equivalent between genders over developmental age. Targeting susceptible adolescents with gender-, race/ethnic-, and age-tailored prevention efforts may prevent or delay adolescents' transition to tobacco use and reduce tobacco-related disparities.
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Affiliation(s)
- Kristyn Kamke
- National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland
| | - Melanie Sabado-Liwag
- Rongxiang Xu College of Health and Human Sciences, California State University, Los Angeles, California
| | - Erik J Rodriquez
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Eliseo J Pérez-Stable
- National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland; National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Sherine El-Toukhy
- National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland.
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Prevalence and Predictors of Smoking among Gambian Men: A Cross-Sectional National WHO STEP Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234719. [PMID: 31779281 PMCID: PMC6926921 DOI: 10.3390/ijerph16234719] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 11/16/2022]
Abstract
Background: Tobacco use is the leading cause of preventable death in the world, with a higher burden in low- and middle-income countries. The aim of this study was to quantify the prevalence and predictors of smoking among Gambian men using nationally representative data. Methods: Data was collected in 2010 from a random, nationally representative sample of 4111 adults aged 25–64 years (78% response rate) using the World Health Organization (WHO) STEPwise cross-sectional survey methods. Our analyses focused on men with valid information on smoking status (n = 1766) because of the low prevalence of smoking among women (1%). Results: The prevalence of current smoking among men was 31.4% (95% CI: 27.2–35.9). The median age of starting smoking was 19 years; 25% started before the age of 18 years and 10% started aged 8–10 years. Rural residence, underweight, and hypertension were significantly associated with smoking. Conclusion: The study reveals a high prevalence of smoking among Gambian men. It is evident that cigarettes are obtained by minors in The Gambia, as a high proportion of current smokers started at a young age. Advice and support to quit smoking should be extended to all smokers regardless of their age and whether or not they have any underlying health conditions.
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13
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Lagerweij NA, Kunst AE, Mélard N, Rimpelä A, Alves J, Hoffmann L, Richter M, Kuipers MA. Where do teens smoke? Smoking locations of adolescents in Europe in relation to smoking bans in bars, schools and homes. Health Place 2019; 60:102213. [DOI: 10.1016/j.healthplace.2019.102213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/28/2019] [Accepted: 09/18/2019] [Indexed: 11/30/2022]
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Yuan NP, Nair US, Crane TE, Krupski L, Collins BN, Bell ML. Impact of changes in home smoking bans on tobacco cessation among quitline callers. HEALTH EDUCATION RESEARCH 2019; 34:345-355. [PMID: 30932151 PMCID: PMC6510015 DOI: 10.1093/her/cyz008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 02/22/2019] [Indexed: 06/09/2023]
Abstract
Home smoking bans may be an effective way to promote tobacco cessation among treatment seeking smokers. Few studies have examined this relationship in a quitline setting. Data were obtained from 14,296 adults who were enrolled in a state quitline between January 2011 and July 2016. This study investigated whether cessation rates varied by changes in home smoking ban implementation between enrollment and 7-month follow-up. The impact of changes in home smoking bans on cessation at follow-up was significantly modified by having other smokers living in the home at follow-up (P < 0.0001). Among callers who did not live with other smokers in the home, the highest odds ratio of 30-day cessation was for callers who reported bans at follow-up only (OR = 10.50, 95%CI: 8.00, 13.70), followed by callers who reported bans at both enrollment and follow-up (OR = 8.02, 95%CI: 6.27, 10.30) and callers who reported bans at enrollment only (OR = 2.06, 95% CI: 1.47, 2.89) compared with callers with no home smoking bans. When callers reported that they lived with other smokers in the home, the effect of home smoking bans on cessation was much smaller. Quitlines should support the implementation of home smoking bans as a part of callers' goal setting activities to achieve tobacco cessation.
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Affiliation(s)
- Nicole P Yuan
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Uma S Nair
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Tracy E Crane
- Division of Biobehavioral Health Sciences, College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Laurie Krupski
- Arizona Smokers’ Helpline, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Bradley N Collins
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Melanie L Bell
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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15
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Kim EM, Park E, Kim H. Sex Differences in Multilevel Factors of Smoking Experimentation and Age of Initiation in Korean Adolescents. J Sch Nurs 2019; 36:348-359. [PMID: 30966858 DOI: 10.1177/1059840519840805] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
This study purpose was to investigate sex differences in multilevel factors associated with smoking experimentation and age of initiation among Korean adolescents. Based on the ecological model, this cross-sectional study used data from the 2016 Korea Youth Risk Behavior Web-Based Survey (N = 65,528). Among 33,803 males (51.6%) and 31,725 females (48.4%), a greater proportion of males (21.9%) than females (7.1%) engaged in smoking experimentation. Males started smoking earlier than females (males: 12.7 years, females: 12.9 years, respectively, p < .05). In both sex groups, common factors associated with smoking were age, depression, suicidal ideation, academic achievement, household economic status, and having friends smoking and a specific person to talk with about their personal concern (all p values <.05). There were significant sex differences in psychological, family, and school factors of smoking initiation and experimentation. It is necessary to develop smoking interventions considering both individual and environmental factors with sex-specific strategies.
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Affiliation(s)
- Eun-Mi Kim
- 26721Yonsei University College of Nursing, Seoul, Republic of Korea.,Department of Nursing, Sunlin University, Pohang-si, Gyeongsangbuk-do, Republic of Korea
| | - Eunhee Park
- School of Nursing, 12292University at Buffalo, Buffalo, NY, USA
| | - Heejung Kim
- 26721Yonsei University College of Nursing, Seoul, Republic of Korea.,Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
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16
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Alves J, Perelman J, Soto-Rojas V, Richter M, Rimpelä A, Loureiro I, Federico B, Kuipers MAG, Kunst AE, Lorant V. The role of parental smoking on adolescent smoking and its social patterning: a cross-sectional survey in six European cities. J Public Health (Oxf) 2018; 39:339-346. [PMID: 27160860 DOI: 10.1093/pubmed/fdw040] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Several studies have observed socio-economic (SE) inequalities in smoking among adolescents, but its causes are not fully understood. This study investigates the association between parental and adolescent smoking, and whether this association is socially patterned. Methods We used data from a survey administered in 2013 to students aged 14-17 years old of six European cities (n = 10 526). Using multilevel mixed-effects logistic regression, we modelled the probability of being a daily smoker as a function of parental smoking and SE status. We tested whether the smoking association differed across social strata. Results The prevalence of parental smoking was higher in low SE status adolescents. Boys and girls were more likely to smoke if they have a father [boys: adjusted odds ratio (AOR) = 1.90, 95% CI = 1.47-2.46; girls: AOR = 1.42, 95% CI = 1.09-1.86] and mother (boys: AOR = 1.77, 95% CI = 1.35-2.31; girls: AOR = 3.36, 95% CI = 2.56-4.40) who smoked. Among boys, the odds of smoking when having a smoking parent were higher in lower SE classes. However, this was not statistically significant, nor was it observed among girls. Conclusions Adolescents are more likely to smoke when their father and mother smoke. Although the susceptibility to parental smoking was similar across social classes, SE differences in parental smoking contribute to the transmission of SE inequalities in smoking.
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Affiliation(s)
- Joana Alves
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
| | - Julian Perelman
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
| | - Victoria Soto-Rojas
- Institute of Health and Society, Université Catholique de Louvain, Clos Chapelle aux Champs 30.05, 1200 Brussels, Belgium.,PROESA, Universidad Icesi. Calle 18 No. 122-135 Pance, Casa Rocha segundo piso - Cali, Colombia
| | - Matthias Richter
- Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06097 Halle (Saale), Germany
| | - Arja Rimpelä
- School of Health Sciences and PERLA - Tampere Centre for Childhood, Youth and Family Research, FIN-33014, University of Tampere, Tampere, Finland
| | - Isabel Loureiro
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
| | - Bruno Federico
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Urban Area of Folcara, 03043 Cassino (FR), Italy
| | - Mirte A G Kuipers
- Department of Public Health, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Vincent Lorant
- Institute of Health and Society, Université Catholique de Louvain, Clos Chapelle aux Champs 30.05, 1200 Brussels, Belgium
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Delgado-Rendon A, Boley Cruz T, Soto D, Baezconde-Garbanati L, Unger JB. Second and Thirdhand Smoke Exposure, Attitudes and Protective Practices: Results from a Survey of Hispanic Residents in Multi-unit Housing. J Immigr Minor Health 2017; 19:1148-1155. [PMID: 28074306 PMCID: PMC7453492 DOI: 10.1007/s10903-016-0540-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Secondhand and third hand smoke (SHS, THS) exposure is prevalent in multi-unit housing (MUH). Minorities and low-income MUH residents are disproportionally exposed to SHS and THS compared to other populations. This study describes the characteristics, attitudes, knowledge, and behaviors related to SHS, THS and marijuana smoke exposure (MSHS) of a sample of Hispanic tenants in randomly selected MUH units in eastern metro Los Angeles (n = 402). Although most participants (97%) banned smoking inside their homes, 80% reported infiltration of SHS inside their apartments within the last year. Most (85%) favored a complete ban on smoking in apartment buildings. Twenty-eight percent did not know that marijuana (MSHS) smoke exposure is also harmful to their health. Knowledge scores were higher among Spanish-speakers (p < 0.05). Given the interpersonal barriers to advocating for change, widespread policy and communication interventions are also necessary to protect Hispanic MUH residents' rights to clean air in their living space.
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Affiliation(s)
- Angelica Delgado-Rendon
- Department of Preventive Medicine, Keck School of Medicine, Institute for Prevention Research, University of Southern California, 2001N. Soto Ave., Los Angeles, CA 90034, USA
| | - Tess Boley Cruz
- Department of Preventive Medicine, Keck School of Medicine, Institute for Prevention Research, University of Southern California, 2001N. Soto Ave., Los Angeles, CA 90034, USA
| | - Daniel Soto
- Department of Preventive Medicine, Keck School of Medicine, Institute for Prevention Research, University of Southern California, 2001N. Soto Ave., Los Angeles, CA 90034, USA
| | - Lourdes Baezconde-Garbanati
- Department of Preventive Medicine, Keck School of Medicine, Institute for Prevention Research, University of Southern California, 2001N. Soto Ave., Los Angeles, CA 90034, USA
| | - Jennifer B. Unger
- Department of Preventive Medicine, Keck School of Medicine, Institute for Prevention Research, University of Southern California, 2001N. Soto Ave., Los Angeles, CA 90034, USA
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18
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Hiemstra M, de Leeuw RN, Engels RC, Otten R. What parents can do to keep their children from smoking: A systematic review on smoking-specific parenting strategies and smoking onset. Addict Behav 2017; 70:107-128. [PMID: 28237717 DOI: 10.1016/j.addbeh.2017.02.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 02/01/2017] [Accepted: 02/08/2017] [Indexed: 11/26/2022]
Abstract
AIM To provide a systematic overview of longitudinal studies on different smoking-specific parenting practices (i.e., perceived parental norms and influences, smoking-specific monitoring, availability of cigarettes at home, household smoking rules, non-smoking agreements, smoking-specific communication, and parental reactions) as useful tools in the prevention of youth smoking. METHOD MEDLINE and PsychINFO search identified 986 studies published from 1990 to December 2016. Two independent researchers identified eligible studies. Study quality was assessed using Newcastle Ottawa Scale (NOS). RESULTS The systematic search resulted in 1 to 14 longitudinal studies per parenting practice. Studies scored between 4 and 9 on the NOS, indicating an overall moderate quality. The results of complete smoking house rules showed a preventive effect on smoking onset. Furthermore, availability of cigarettes, frequency and quality of communication, parental reaction (i.e., conflict engagement) and norms showed significant and non-significant effects. Significant results were in line with expectations: availability of cigarettes and frequent communication about smoking predicted smoking, whereas a high quality of communication, negative reactions or punishments and setting norms by parents showed a preventive effect. No effects were found for non-smoking agreements. The number of studies was too limited to draw conclusions about other parenting strategies. More research on (1) reliable and valid instruments, (2) other stages of smoking in addition to onset, and (3) potential moderators and mediators is warranted. CONCLUSION While evidence supports the effectiveness of smoking-specific parenting, further research is required.
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19
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Helms VE, King BA, Ashley PJ. Cigarette smoking and adverse health outcomes among adults receiving federal housing assistance. Prev Med 2017; 99:171-177. [PMID: 28192095 PMCID: PMC5508864 DOI: 10.1016/j.ypmed.2017.02.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/01/2017] [Accepted: 02/01/2017] [Indexed: 11/19/2022]
Abstract
Cigarette smoking is higher among low-income adults and individuals who reside in federally assisted housing are particularly susceptible to the adverse effects of smoking and secondhand smoke exposure. This study assessed smoking-related behaviors and health outcomes among U.S. adults who received federal housing assistance during 2006-2012. National Health Interview Survey data linked with administrative data from the U.S. Department of Housing and Urban Development were analyzed; 5218 HUD-assisted adults were assessed. Demographic characteristics associated with smoking, including frequency and consumption, were assessed among adult cigarette smokers. Fourteen adverse health outcomes were examined among cigarette smoking and nonsmoking adults. One-third (33.6%) of HUD-assisted adults were current cigarette smokers. Smoking prevalence was highest among adults aged 25-44 (42.5%), non-Hispanic whites (39.5%), and adults who resided in households with children (37.5%). Half attempted to quit in the past year; 82.1% were daily smokers; and, 35.8% of daily smokers reported smoking 20+ cigarettes a day. Multivariable analyses revealed that compared to nonsmokers, cigarette smokers had increased likelihood of reporting fair or poor health (95% CI: 1.04-1.52), chronic obstructive pulmonary disease (CI: 1.87-3.06), disability (CI: 1.25-1.83), asthma (CI: 1.02-1.55), serious psychological distress (CI: 1.39-2.52), >1 emergency room visit in the past year (CI: 1.09-1.56), and ≥10 work loss days in the past year (CI: 1.15-3.06). Adults who receive housing assistance represent an at-risk population for adverse health outcomes associated with smoking and secondhand smoke. Housing assistance programs provide a valuable platform for the implementation of evidence-based tobacco prevention and control measures, including smokefree policies.
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Affiliation(s)
- Veronica E Helms
- Office of Research, Evaluation, and Monitoring, Office of Policy Development and Research, U.S. Department of Housing and Urban Development, Washington, DC, United States.
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Peter J Ashley
- Office of Lead Hazard Control and Healthy Homes, U.S. Department of Housing and Urban Development, Washington, DC, United States
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Lee J, Han AR, Choi D, Lim KM, Bae S. Modeling lifetime costs and health outcomes attributable to secondhand smoke exposure at home among Korean adult women. BMJ Open 2017; 7:e013292. [PMID: 28515183 PMCID: PMC5623422 DOI: 10.1136/bmjopen-2016-013292] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The aim of this research is to estimate lifetime costs and health consequences for Korean adult women who were exposed to secondhand smoke (SHS) at home. METHODS A Markov model was developed to project the lifetime healthcare costs and health outcomes of a hypothetical cohort of Korean women who are 40 years old and were married to current smokers. The Korean epidemiological data were used to reflect the natural history of SHS-exposed and non-exposed women. The direct healthcare costs (in 2014 US dollars) and quality-adjusted life years (QALYs) were annually discounted at 5% to reflect time preference. The time horizon of the analysis was lifetime and the cycle length was 1 year. Deterministic and probabilistic sensitivity analyses were conducted. RESULTS In the absence of SHS exposure, Korean women will live 41.32 years or 34.56 QALYs before discount, which corresponded to 17.29 years or 15.35 QALYs after discount. The SHS-exposed women were predicted to live 37.91 years and 31.08 QALYs before discount and 16.76 years and 14.62 QALYs after discount. The estimated lifetime healthcare cost per woman in the SHS non-exposed group was US$11 214 before the discount and US$2465 after discount. The negative impact of SHS exposure on health outcomes and healthcare costs escalated as the time horizon increased, suggesting that the adverse impact of SHS exposure may have higher impact on the later part of the lifetime. The result was consistent across a wide range of assumptions. CONCLUSION Life expectancy might underestimate the impact of SHS exposure on health outcomes, especially if the time horizon of the analysis is not long enough. Early intervention on smoking behaviour could substantially reduce direct healthcare costs and improve quality of life attributable to SHS exposure.
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Affiliation(s)
- Jiyae Lee
- College of Pharmacy, Ewha Womans University, Seoul, Republic of Korea
| | - Ah Ram Han
- College of Pharmacy, Ewha Womans University, Seoul, Republic of Korea
| | - Dalwoong Choi
- Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea
| | - Kyung-Min Lim
- College of Pharmacy, Ewha Womans University, Seoul, Republic of Korea
| | - SeungJin Bae
- College of Pharmacy, Ewha Womans University, Seoul, Republic of Korea
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Milcarz K, Bak-Romaniszyn L, Kaleta D. Environmental Tobacco Smoke Exposure and Smoke-Free Rules in Homes among Socially-Disadvantaged Populations in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E447. [PMID: 28430128 PMCID: PMC5409647 DOI: 10.3390/ijerph14040447] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/05/2017] [Accepted: 04/19/2017] [Indexed: 11/17/2022]
Abstract
This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS) in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed in the Piotrkowski District were used, which was part of the "Reducing Social Inequalities in Health" program. Overall, 19.4% of the respondents declared exposure to ETS at home. In the non-smokers group, 15.5%, including 6.6% males and 18.3% females, were exposed to ETS in their place of residence (p < 0.0001). Complete smoke-free rules were adopted by 22.1% of the study participants. Two factors, smoker status and lack of ETS-associated health risk awareness, were found to be significantly associated with no adoption of total smoking bans at home. Socially-disadvantaged non-smokers, especially females from rural areas in Poland, still constitute a large population exposed to ETS in their homes-a challenge from the perspective of public health. Focused efforts are required to address social norms around exposing others to ETS.
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Affiliation(s)
- Katarzyna Milcarz
- Department of Tobacco Control, Preventive Medicine Department, Medical University of Lodz, 90-752 Lodz, Poland.
| | - Leokadia Bak-Romaniszyn
- Department of Nutrition in Digestive Tract Diseases, Medical University of Lodz, 93-338 Lodz, Poland.
| | - Dorota Kaleta
- Department of Tobacco Control, Preventive Medicine Department, Medical University of Lodz, 90-752 Lodz, Poland.
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22
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Steinberg ML, Stahl NF, Williams JM. Household Smoking Restrictions Relate To Time To First Cigarette Smoked In The Morning. J Smok Cessat 2017; 12:1-5. [PMID: 38572325 PMCID: PMC10989735 DOI: 10.1017/jsc.2015.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction The time a smoker waits until the first cigarette of the morning is often used as a measure of dependence with the rationale that more dependent smokers will smoke sooner upon waking than will less dependent smokers after going several hours without a cigarette overnight. Aims We sought to examine the relationship between time-to-first-cigarette (TTFC) and household smoking restrictions in two independent samples. Methods Two samples of smokers, one treatment-seeking community sample (N = 433) and one non-treatment-seeking sample of smokers with serious mental illness (i.e., Schizophrenia, Schizoaffective Disorder, or Bipolar I Disorder) (N = 94), provided information on cigarette dependence with the Fagerström Test for Nicotine Dependence and on household smoking restrictions. Results Half (50%) of smokers with serious mental illness and 36.7% of smokers from the general population reported that there were no limitations to smoking in their home. Household smoking restrictions were significantly and positively related to TTFC in both samples. Conclusions These data indicate that greater attention to TTFC may be warranted. The TTFC item is intended to measure dependence based on the premise that greater dependence should be associated with shorter TTFC. If TTFC is related to a household smoking ban, however, this item may not be assessing dependence as intended in some cases.
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Affiliation(s)
- Marc L Steinberg
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Naomi F Stahl
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Jill M Williams
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
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McKelvey K, Halpern-Felsher B. Adolescent Cigarette Smoking Perceptions and Behavior: Tobacco Control Gains and Gaps Amidst the Rapidly Expanding Tobacco Products Market From 2001 to 2015. J Adolesc Health 2017; 60:226-228. [PMID: 27939880 PMCID: PMC5270372 DOI: 10.1016/j.jadohealth.2016.09.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/07/2016] [Accepted: 09/29/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of the study was to determine whether adolescents' intentions to smoke, cigarette smoking behavior, and specific perceptions of cigarette smoking are different in 2015 versus 2001. METHODS Data from two California school-based studies (Xage = 14) were compared: one conducted in 2001-2002 ("2001"), N = 395; the second in 2014-2015 ("2015"); N = 282. RESULTS In 2015, more participants reported it was very unlikely they would smoke (94% vs. 65%) and that they never smoked (95% vs. 74%); they reported perceiving less likelihood of looking more mature (17% vs. 28%) and greater likelihood of getting into trouble (86% vs. 77%), having a heart attack (76% vs. 69%), and contracting lung cancer (85% vs. 78%) from smoking (p < .001). Perceptions of short-term health problems and addiction were similar in 2001 and 2015. CONCLUSIONS Findings suggest that adolescents in 2015 perceived greater risks compared to those in 2001 even amidst the rapidly changing tobacco product landscape. In addition to continuing messages of long-term health risks, prevention efforts should include messages about addiction and short-term health and social risks.
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Affiliation(s)
- Karma McKelvey
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California.
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Allen ML, Hurtado GA, Garcia-Huidobro D, Davey C, Forster J, Reynoso U, Alvarez de Davila S, Linares R, Gonzales N, Veronica Svetaz M. Cultural Contributors to Smoking Susceptibility Outcomes Among Latino Youth: The Padres Informados/Jovenes Preparados Participatory Trial. FAMILY & COMMUNITY HEALTH 2017; 40:170-179. [PMID: 28207680 PMCID: PMC5412730 DOI: 10.1097/fch.0000000000000147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Padres Informados/Jovenes Preparados is a community-based participatory, family-focused tobacco prevention intervention for immigrant Latino families of adolescents. We conducted a participatory randomized controlled trial including 352 Latino families. Parents and youth in the intervention condition engaged in eight family skill building sessions. Participants completed baseline and 6-month postintervention surveys assessing smoking susceptibility and contextual factors. While the intervention did not affect smoking susceptibility overall, it resulted in lower smoking susceptibility among youth in families with less adherence to traditional Latino cultural values. This family cultural orientation is a key consideration for tobacco prevention interventions focused on Latino youth.
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Affiliation(s)
- Michele L Allen
- Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis (Drs Allen and Garcia-Huidobro); Center for Family Development, University of Minnesota Extension, St Paul (Drs Hurtado and Alvarez de Davila); Department of Family Social Science, University of Minnesota, St Paul (Dr Garcia-Huidobro); Department of Family Medicine, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile (Dr Garcia-Huidobro); Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis (Ms Davey); Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis (Dr Forster); Department of Family and Community Medicine, Aquí Para Ti/Here for You Clinic for Latino Youth, Hennepin County Medical Center, Minneapolis, Minnesota (Ms Reynoso and Dr Veronica Svetaz); Centro Tyrone Guzman, Minneapolis, Minnesota (Ms Linares); and Department of Psychology, Arizona State University, Tempe (Dr Gonzales)
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Predictors of the Onset of Cigarette Smoking: A Systematic Review of Longitudinal Population-Based Studies in Youth. Am J Prev Med 2016; 51:767-778. [PMID: 27180028 DOI: 10.1016/j.amepre.2016.04.003] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/17/2016] [Accepted: 04/01/2016] [Indexed: 11/23/2022]
Abstract
CONTEXT The onset of cigarette smoking typically occurs during childhood or early adolescence. Nicotine dependence symptoms can manifest soon after onset, contributing to sustained, long-term smoking. Previous reviews have not clarified the determinants of onset. EVIDENCE ACQUISITION In 2015, a systematic review of the literature in PubMed and EMBASE was undertaken to identify peer-reviewed prospective longitudinal studies published between January 1984 and August 2015 that investigated predictors of cigarette smoking onset among youth aged <18 years who had never smoked. EVIDENCE SYNTHESIS Ninety-eight conceptually different potential predictors were identified in 53 studies. An increased risk of smoking onset was consistently (i.e., in four or more studies) associated with increased age/grade, lower SES, poor academic performance, sensation seeking or rebelliousness, intention to smoke in the future, receptivity to tobacco promotion efforts, susceptibility to smoking, family members' smoking, having friends who smoke, and exposure to films, whereas higher self-esteem and high parental monitoring/supervision of the child appeared to protect against smoking onset. Methodologic weaknesses were identified in numerous studies, including failure to account for attrition or for clustering in samples, and misidentification of potential confounders, which may have led to biased estimates of associations. CONCLUSIONS Predictors of smoking onset for which there is robust evidence should be considered in the design of interventions to prevent first puff in order to optimize their effectiveness. Future research should seek to define onset clearly as the transition from never use to first use (e.g., first few puffs).
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Nguyen KH, Gomez Y, Homa DM, King BA. Tobacco Use, Secondhand Smoke, and Smoke-Free Home Rules in Multiunit Housing. Am J Prev Med 2016; 51:682-692. [PMID: 27423656 PMCID: PMC5821129 DOI: 10.1016/j.amepre.2016.05.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/03/2016] [Accepted: 05/11/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Multiunit housing (MUH) residents are particularly susceptible to involuntary secondhand smoke (SHS) exposure in their home, which can enter their living units from nearby units and shared areas where smoking occurs. To date, no study has assessed non-cigarette tobacco use among MUH residents. This study assessed the prevalence and sociodemographic correlates of tobacco use (combustible, noncombustible, any tobacco use including electronic cigarettes), smoke-free home rules, and SHS incursions among U.S. MUH residents. METHODS Data came from the 2013-2014 National Adult Tobacco Survey, a telephone survey of U.S. adults aged ≥18 years. Analyses were conducted in 2015. Prevalence of current tobacco use and smoke-free home rules were assessed overall and by sociodemographics, stratified by housing type (single family versus MUH). Prevalence and adjusted odds of SHS incursions among MUH residents with smoke-free home rules were assessed. RESULTS Tobacco use was higher among adults living in MUH (24.7%) than those in single-family housing (18.9%, p<0.05). Smoke-free home rules were higher among adults living in single-family housing (86.7%) than those in MUH (80.9%, p<0.05). Among MUH residents with smoke-free homes, 34.4% experienced SHS incursions. Adjusted odds of SHS incursions were greater among women, younger adults, non-Hispanic blacks, Hispanics, and those with lower income. CONCLUSIONS One quarter of MUH residents use tobacco, and one third of MUH residents with smoke-free rules experience SHS incursions. Interventions are warranted to promote tobacco cessation and smoke-free building policies to protect all MUH residents, employees, and visitors from the dangers of tobacco use and SHS.
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Affiliation(s)
- Kimberly H Nguyen
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Yessica Gomez
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David M Homa
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Lee KA, Palipudi KM, English LM, Ramanandraibe N, Asma S. Secondhand smoke exposure and susceptibility to initiating cigarette smoking among never-smoking students in selected African countries: Findings from the Global Youth Tobacco Survey. Prev Med 2016; 91S:S2-S8. [PMID: 27138692 DOI: 10.1016/j.ypmed.2016.04.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 04/15/2016] [Accepted: 04/28/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Exposure to secondhand smoke (SHS) causes premature death and illness in non-smokers. We examined SHS exposure at home and in public places, as well as susceptibility to initiate cigarette smoking among never cigarette smokers. We used 2006-2011 Global Youth Tobacco Survey (GYTS) data from 29 African countries (56,967 students). METHODS GYTS is a nationally representative, self-administered school-based survey, conducted among students aged 13-15years. Prevalence ratio, estimates and 95% confidence intervals were computed for SHS exposure in the homes and public places separately. The two-sample t-test was used to assess the difference in susceptibility to smoking by SHS exposure among never-smoking students (α=0.05). RESULTS Among never-smoking students, exposure to SHS at home ranged from 12.7% (Cape Verde) to 44.0% (Senegal). The prevalence ratio (PR) comparing susceptibility to smoking initiation among never smokers exposed to SHS at home to those who were not exposed at home ranged from 1.2 to 2.6. Exposure to SHS in public places ranged from 23.9% (Cape Verde) to 80.4% (Mali). Of the countries being studied, 8 countries showed a significant difference in susceptibility to smoking initiation among never smokers exposed to SHS in public places compared to those not exposed in public places. (PR ranged from 0.5-3.5). CONCLUSION In many African countries in the study, a substantial proportion of students who never smoked are exposed to SHS at home and in public places. Majority of never smokers who were exposed to SHS at home and in public places had a higher prevalence of susceptibility to initiate smoking than those that were not exposed to SHS at home and in public places. Adoption and enforcement of smoke-free policies in public places and smoke-free rules at home could substantially contribute to reducing SHS exposure in many of these countries.
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Affiliation(s)
- Kyung A Lee
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States; Northrop Grumman Information Systems, Atlanta, GA, United States
| | - Krishna M Palipudi
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Lorna M English
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nivo Ramanandraibe
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Samira Asma
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Tobacco and Alcohol Use and the Impact of School Based Antitobacco Education for Knowledge Enhancement among Adolescent Students of Rural Kerala, India. JOURNAL OF ADDICTION 2016; 2016:9570517. [PMID: 27630784 PMCID: PMC5005535 DOI: 10.1155/2016/9570517] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/12/2016] [Indexed: 12/29/2022]
Abstract
Objectives. Limited information is available on adolescent tobacco and alcohol use in rural Kerala, the southernmost state in India. The study was conducted to estimate the prevalence of tobacco and alcohol use among adolescent school students and further to understand the extent of knowledge pertaining to tobacco before and after conducting awareness programmes in schools. Methods. A cross-sectional study was conducted in 10 government schools of rural Thiruvananthapuram district of Kerala state based on a multistaged sampling design. Using a pretested semistructured questionnaire, prevalence and patterns of tobacco use by students and their households, as well as students' knowledge on tobacco hazards before and after delivering antitobacco messages, were collected. Results. The overall prevalence of self-reported ever users of tobacco in the current academic year was 7.4% (95% CI 5.86-8.94), while that of ever alcohol users was 5.6% (95% CI 4.25-6.95). Knowledge assessment scores revealed a significant increase in the mean knowledge scores after posttraining evaluation (mean score = 10.34) when compared to pretraining evaluation (mean score = 9.26) (p < 0.0001). Conclusion. Apart from antitobacco awareness programmes, strict monitoring of trade of tobacco and alcohol products near educational institutions has to be conducted consistently to curb the problem.
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Gorini G, Carreras G, Cortini B, Verdi S, Petronio MG, Sestini P, Chellini E. Smoke-Free Homes and Youth Smoking Behavior in Italy: Findings From the SIDRIAT Longitudinal Study. Nicotine Tob Res 2016; 18:2075-2082. [PMID: 27287390 DOI: 10.1093/ntr/ntw149] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 05/25/2016] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Few studies have explored whether smoke-free homes (SFH) can promote reductions of smoking onset in children, particularly in households with smoking parents. The aim of this study was to determine whether youths living in SFH were less likely to progress to smoking. METHODS We conducted a longitudinal, 11-year, two-wave study on 778 children aged 6-7 years and 985 adolescents aged 13-14 in 2002. At baseline, youths were asked whether or not adults smoked at home (SFH); at follow-up, in 2012-2014, whether a household smoking ban (HSB) had been implemented during the course of the study. Logistic regression was used to investigate SFH effects on youth smoking behaviors. RESULTS Sixty-nine percent of children and 54% of adolescents reported SFH at baseline; 80% of children and 71% of adolescents reported HSB at follow-up. Youths living in non-SFH at baseline were twice as likely to become established smokers at follow-up compared with those living in SFH (children + adolescents: odds ratio [OR] = 1.99; 95% confidence interval [CI] = 1.39-2.94; adolescents: OR = 2.15; 95% CI = 1.36-3.42; children: OR = 1.69; 95% CI = 0.80-3.56), either for youths living with nonsmoking parents at baseline and follow-up (OR for both children and adolescents = 3.06; 95% CI = 1.70-5.51) or for youths with ≥1 smoking parent at baseline and follow-up (OR = 2.12, 95% CI = 1.01-4.46). The effect was greater in youths living in the worst situation (non-SFH at baseline + non-HSB at follow-up) compared with those in the best situation (SFH at baseline + HSB at follow-up; children: OR = 3.20; 95% CI = 1.10-9.35; adolescents: OR = 5.41; 95% CI = 2.66-10.97). CONCLUSIONS Household smoke-free policies had a significant impact in protecting youths from becoming established smokers. IMPLICATIONS The results of the SIDRIAT longitudinal study showed that youths living in homes where people smoked at baseline were twice as likely to become established smokers 11 years later at follow-up, compared with youths living in SFH. The lower number of established smokers among youths living in SFH at baseline was recorded not only in households with nonsmoking parents but also in those with smoking parents. Implementing a home smoking ban is recommended in all households. Living in homes with no ban may be a risk factor for smoking initiation, which is independent of having smoking parents.
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Affiliation(s)
- Giuseppe Gorini
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence, Italy;
| | - Giulia Carreras
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence, Italy
| | - Barbara Cortini
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence, Italy
| | - Simona Verdi
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence, Italy
| | | | - Piersante Sestini
- Section of Phthisiology and Diseases of Respiratory Tract, Siena University, Siena, Italy
| | - Elisabetta Chellini
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence, Italy
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Gregoire B, Azagba S, Asbridge M. Smoke-free homes, smoking susceptibility and familial smoking among never-smoking high school students: a cross-sectional analysis. CMAJ Open 2016; 4:E298-303. [PMID: 27398377 PMCID: PMC4933637 DOI: 10.9778/cmajo.20160010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Research has shown that living in a smoke-free home has a positive effect on adolescents' perceived acceptance of smoking. However, the relationship between smoke-free homes and adolescent smoking behaviours remains unclear. The aim of this study was to examine the association between smoke-free homes and smoking susceptibility among high school students, and to determine whether these associations persist when analyses are stratified by familial smoking status. METHODS We conducted a random cross-sectional survey (2012/2013 Youth Smoking Survey) of primary, junior and high school students in Canada (n = 47 203). Multivariable logistic regression analyses were used to examine the associations between smoke-free homes and susceptibility to smoking among never-smoking high school students, with and without stratification by familial smoking. RESULTS Analyses showed that adolescents living in a smoke-free home had reduced odds of being susceptible to smoking (odds ratio [OR] 0.582, 95% confidence interval [CI] 0.428-0.791) compared with their peers living in households where smoking was permitted. When adolescents had other family members who were smokers, having a smoke-free home was not significantly associated with reduced smoking susceptibility (OR 0.878, 95% CI 0.721-1.071). INTERPRETATION Our results suggest that smoke-free homes may influence future smoking initiation. Optimal success in preventing youth smoking uptake necessitates having a coherent antismoking message between the home smoking environment and familial smoking behaviour.
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Affiliation(s)
- Bruce Gregoire
- Department of Community Health and Epidemiology (Gregoire, Asbridge), Dalhousie University, Halifax, NS; Propel Centre for Population Health Impact (Azagba), School of Public Health and Health Systems, University of Waterloo, Waterloo, Ont
| | - Sunday Azagba
- Department of Community Health and Epidemiology (Gregoire, Asbridge), Dalhousie University, Halifax, NS; Propel Centre for Population Health Impact (Azagba), School of Public Health and Health Systems, University of Waterloo, Waterloo, Ont
| | - Mark Asbridge
- Department of Community Health and Epidemiology (Gregoire, Asbridge), Dalhousie University, Halifax, NS; Propel Centre for Population Health Impact (Azagba), School of Public Health and Health Systems, University of Waterloo, Waterloo, Ont
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Kegler MC, Haardörfer R, Bundy LT, Escoffery C, Berg CJ, Fernandez M, Williams R, Hovell M. Do partial home smoking bans signal progress toward a smoke-free home? HEALTH EDUCATION RESEARCH 2016; 31:24-35. [PMID: 26661723 PMCID: PMC4883035 DOI: 10.1093/her/cyv066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 11/06/2015] [Indexed: 06/05/2023]
Abstract
Understanding who establishes partial home smoking bans, what these bans cover, and whether they are an intermediate step in going smoke-free would help to inform smoke-free home interventions. Participants were recruited from United Way of Greater Atlanta's 2-1-1 contact center. Data were collected at baseline, 3 and 6 months via telephone interview. Participants (n = 375) were mostly African American (84.2%) and female (84.3%). The majority (58.5%) had annual household incomes <$10,000. At baseline, 61.3% reported a partial smoking ban and 38.7% reported no ban. Existence of a partial ban as compared with no ban was associated with being female, having more than a high school education, being married and younger age. Partial bans most often meant smoking was allowed only in designated rooms (52.6%). Other common rules included: no smoking in the presence of children (18.4%) and smoking allowed only in combination with actions such as opening a window or running a fan (9.8%). A higher percentage of households with partial bans at baseline were smoke-free at 6 months (36.5%) compared with households with no bans at baseline (22.1%). Households with partial smoking bans may have a higher level of readiness to go smoke-free than households with no restrictions.
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Affiliation(s)
- Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322,
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322
| | - Lucja T Bundy
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322
| | - Maria Fernandez
- School of Public Health, University of Texas Health Sciences Center, Houston, TX 77030
| | - Rebecca Williams
- Gillings School of Global Public Health, Chapel Hill, University of North Carolina, Chapel Hill, NC 27510 and
| | - Mel Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA 91941, USA
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Factors Associated with Complete Home Smoking Ban among Chinese Parents of Young Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:161. [PMID: 26821038 PMCID: PMC4772181 DOI: 10.3390/ijerph13020161] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/19/2016] [Accepted: 01/21/2016] [Indexed: 11/30/2022]
Abstract
(1) Background: The home environment is a major source of Environmental Tobacco Smoke (ETS) exposure among children especially in early childhood. ETS exposure is an important health risk among children and can cause severe and chronic diseases, such as asthma, bronchitis, and premature death. However, ETS exposure at home has often been neglected in the Chinese families. Identification of factors that facilitate or otherwise hamper the adoption of home smoking ban will help in the design and implementation of evidence-based intervention programs. This study identifies factors correlated with home smoking bans in Chinese families with children. (2) Methods: A cross-sectional survey of parents living in Nanning city, Guangxi Province, China with at least one smoker and a child in the household was conducted between September, 2013 and January, 2014. A Chi-square test was used to compare categorical variables differences between the parents who had home smoking bans and those with no home smoking ban. Multiple logistic regression analyses were used to identify factors correlated with home smoking bans. (3) Results: 969 completed questionnaires were collected with a response rate of 92.29% (969/1050). Of the respondents (n = 969), 14.34% had complete home smoking bans. Factors that were associated with home smoking bans were: having no other smokers in the family (OR = 2.173), attaining education up to high school (OR = 2.471), believing that paternal smoking would increase the risk of lower respiratory tract illnesses (OR = 2.755), perceiving the fact that smoking cigarettes in the presence of the child will hurt the child’s health (OR = 1.547), believing that adopting a no smoking policy at home is very important (OR = 2.816), and being confident to prevent others to smoke at home (OR = 1.950). Additionally, parents who perceived difficulty in adopting a no smoking policy at home would not have a home smoking ban (OR = 0.523). (4) Conclusions: A home smoking ban is not widely adopted by families of hospitalized children in Guangxi Province, China. To protect the health of children, there is a need to develop and test interventions to promote home smoking bans. Factors identified as predictors of home smoking ban should be considered in the design of interventions.
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So ES, Yeo JY. Factors Associated with Early Smoking Initiation among Korean Adolescents. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9:115-9. [PMID: 26160239 DOI: 10.1016/j.anr.2015.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 12/29/2014] [Accepted: 01/02/2015] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study was to identify factors associated with early initiation of cigarette smoking among Korean adolescents. METHODS A secondary analysis was conducted on the 2012 Korea Youth Risk Behavior Web-based Survey data using Cox proportional hazards regression. RESULTS Early smoking initiation was associated with being male, having a positive subjective health status, perceiving oneself as thin or average weight (body image), having an average happiness level, being stressed, consuming alcohol, having suicidal ideation, experiencing sexual intercourse, having low or average academic grades, having a parental education level of high school or below, not taking a family trip in the previous 12 months, and having a family that approves of smoking in the home. CONCLUSIONS Interventions targeting the prevention of smoking initiation among adolescents should include individual factors such as health status, body weight, perceived mental health status, health-risk behaviors, and academic characteristics as well as family factors that reinforce family cohesion and home smoking bans. Moreover, male adolescents aged 12-13 years and their parents should be the main target of these interventions.
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Affiliation(s)
- Eun Sun So
- College of Nursing, Chonbuk National University, Jeonju, South Korea
| | - Ji Young Yeo
- Department of Nursing, Seoul Women's College of Nursing, Seoul, South Korea.
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Zhang X, Martinez-Donate AP, Cook J, Piper ME, Berg K, Jones NR. Battling tobacco use at home: an analysis of smoke-free home rules among U.S. veterans from 2001 to 2011. Am J Public Health 2014; 104 Suppl 4:S572-9. [PMID: 25100423 DOI: 10.2105/ajph.2014.301975] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined national trends in smoke-free home rules among U.S. veterans and nonveterans. METHODS We used data from the 2001-2002 and 2010-2011 Tobacco Use Supplement to the Current Population Survey to estimate and compare the existence of smoke-free home rules among veterans and nonveterans for each survey period. RESULTS The prevalence of a complete smoke-free home rule among veterans increased from 64.0% to 79.7% between 2001 and 2011 (P < .01) but was consistently lower than were rates estimated for nonveterans (67.6% and 84.4%, respectively). Disparities between the 2 groups increased significantly over time (P < .05). CONCLUSIONS Despite the general increase in the adoption of smoke-free home rules, veterans lag behind the rest of the U.S. population. Interventions promoting the adoption of complete smoke-free home rules are necessary to protect veterans and their families and to reduce disparities.
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Affiliation(s)
- Xiao Zhang
- Xiao Zhang and Ana P. Martinez-Donate are with the Department of Population Health Sciences, University of Wisconsin, Madison. Jessica Cook, Megan E. Piper, and Kristin Berg are with the University of Wisconsin Center for Tobacco Research and Intervention. Nathan R. Jones is with the University of Wisconsin Survey Center
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Müller-Riemenschneider F, Krist L, Bürger C, Ströbele-Benschop N, Roll S, Rieckmann N, Müller-Nordhorn J, Willich SN. Berlin evaluates school tobacco prevention - BEST prevention: study design and methodology. BMC Public Health 2014; 14:871. [PMID: 25150368 PMCID: PMC4155099 DOI: 10.1186/1471-2458-14-871] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 07/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The hazardous health effects of smoking are established, but there remains a need to evaluate existing smoking prevention strategies and to increase their effectiveness in adolescents. Strategies focusing on parental attitudes and rule setting have been identified as a potentially effective approach. The present manuscript describes objectives, study design and methodology of the BEST Prevention study. METHODS/DESIGN BEST Prevention is a three-armed cluster randomized-controlled trial among 7th grade (11-16 years) students in Berlin, Germany. Schools were enrolled between 2010 and 2011 and allocated using a centralized randomization list into 1) a student smoking prevention intervention (visit to an established interactive circuit), 2) the same intervention plus a parent intervention, and 3) a control group (visit to an established exercise and nutrition interactive circuit). Students were assessed at baseline, 12 and 24 months via self-report, as well as via carbon monoxide and cotinine in saliva at the 24 month follow-up. Statistical analyses uses multi-level regression models with cluster effects (school and class within school) based on the intention to treat population. Here we report descriptive baseline characteristics of recruited schools, and schools classes. Two schools from the control group dropped out after allocation. Hence, 47 secondary schools from all 12 districts of the city, including 161 school classes and 3023 students are participating in the study. Of those, 2801 students completed the baseline assessment. DISCUSSION The present manuscript provides details on the study design and methodology of a large school-based smoking prevention trial in a metropolitan area in Germany. Findings from this study will yield important insight into the long-term effectiveness of specific smoking prevention strategies, also in disadvantaged population groups. TRIAL REGISTRATION NCT01306552 (January 2011).
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Affiliation(s)
- Falk Müller-Riemenschneider
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin, Luisenstrasse 57, 10117 Berlin, Germany
- />Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, Singapore, 117597 Singapore
| | - Lilian Krist
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin, Luisenstrasse 57, 10117 Berlin, Germany
| | - Christin Bürger
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin, Luisenstrasse 57, 10117 Berlin, Germany
| | - Nanette Ströbele-Benschop
- />Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstraße 12, 70599 Stuttgart, Germany
| | - Stephanie Roll
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin, Luisenstrasse 57, 10117 Berlin, Germany
| | - Nina Rieckmann
- />Berlin School of Public Health, Charité Universitätsmedizin, Seestraße 73, 13347 Berlin, Germany
| | | | - Stefan N Willich
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin, Luisenstrasse 57, 10117 Berlin, Germany
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Huang HW, Lu CC, Yang YH, Huang CL. Smoking behaviours of adolescents, influenced by smoking of teachers, family and friends. Int Nurs Rev 2014; 61:220-7. [DOI: 10.1111/inr.12084] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - C.-C. Lu
- Department of Family Medicine; Changhua Christian Hospital Erlin Branch; Changhua Taiwan
| | - Y.-H. Yang
- School of Pharmacy and Biostatistic Center; Kaohsiung Medical University; Kaohsiung Taiwan
| | - C.-L. Huang
- Department of Nursing; Chang Jung Christian University; Tainan Taiwan
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Mathur C, Stigler MH, Erickson DJ, Perry CL, Forster JL. Transitions in smoking behavior during emerging adulthood: a longitudinal analysis of the effect of home smoking bans. Am J Public Health 2014; 104:715-20. [PMID: 24524528 DOI: 10.2105/ajph.2013.301642] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We studied the effect of home smoking bans on transitions in smoking behavior during emerging adulthood. METHODS We used latent transition analysis to examine movement between stages of smoking from late adolescence (ages 16-18 years) to young adulthood (ages 18-20 years) and the effect of a home smoking ban on these transitions. We used data from the Minnesota Adolescent Community Cohort study collected in 2004 to 2006. RESULTS Overall, we identified 4 stages of smoking: (1) never smokers, (2) experimental smokers, (3) light smokers, and (4) daily smokers. Transition probabilities varied by stage. Young adults with a home ban during late adolescence were less likely to be smokers and less likely to progress to higher use later. Furthermore, the protective effect of a home smoking ban on the prevalence of smoking behavior was evident even in the presence of parental smoking. However, this effect was less clear on transitions over time. CONCLUSIONS In addition to protecting family members from exposure to secondhand smoke, home smoking bans appear to have the additional benefit of reducing initiation and escalation of smoking behavior among young adults.
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Affiliation(s)
- Charu Mathur
- Charu Mathur, Darin J. Erickson, and Jean L. Forster are with the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis. Melissa H. Stigler and Cheryl L. Perry are with the Division of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas, Austin
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Hovell MF, Adams MA, Hofstetter CR, Martínez-Donate AP, González-Pérez GJ, Rovniak LS, Boman-Davis MC. Complete home smoking bans and antitobacco contingencies: a natural experiment. Nicotine Tob Res 2014; 16:186-96. [PMID: 23999652 PMCID: PMC3880233 DOI: 10.1093/ntr/ntt130] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The California antitobacco culture may have influenced home smoking bans in Mexico. Based on the Behavioral Ecological Model, exposure to socially reinforcing contingencies or criticism may explain adoption of home smoking bans in Tijuana, Mexico, approximating rates relative to San Diego, California, and higher than those in Guadalajara, Mexico. METHODS A representative cross-sectional population survey of Latinos (N = 1,901) was conducted in San Diego, Tijuana, and Guadalajara between June 2003 and September 2004. Cities were selected to represent high-, medium-, and low-level exposure to antitobacco social contingencies of reinforcement in a quasiexperimental analysis of possible cultural influences across borders. RESULTS Complete home smoking ban prevalence was 91% in San Diego, 66% in Tijuana, and 38% in Guadalajara (p < .001). Sample cluster-adjusted logistic regression showed significantly lower odds of complete home smoking bans in Guadalajara (odds ratio [OR] = .048) and in Tijuana (OR = .138) compared to San Diego after control for demographics. Odds of complete home smoking bans in both Guadalajara and Tijuana in comparison with San Diego were weakened when mediators for bans were controlled in predictive models. Direction of association was consistent with theory. When theoretical mediators were explored as possible moderators, weak and nonsignificant associations were obtained for all interaction terms. Bootstrap analyses demonstrated that our multivariable logistic regression results were reliable. CONCLUSIONS Results suggest that California antismoking social contingencies mediate complete home smoking bans in all 3 cities and may account for the greater effects in Tijuana contrasted with Guadalajara.
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Affiliation(s)
- Melbourne F. Hovell
- Centre for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, CA
| | - Marc A. Adams
- Department of Psychology, Graduate School of Public Health, San Diego State University, CA;,Exercise and Wellness, School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ
| | - C. Richard Hofstetter
- Centre for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, CA;,Department of Political Science, Graduate School of Public Health, San Diego State University, CA
| | - Ana P. Martínez-Donate
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Guillermo J. González-Pérez
- Departamento de Ciencias Sociales, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México
| | - Liza S. Rovniak
- Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA
| | - Marie C. Boman-Davis
- Centre for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, CA
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Hock LK, Ghazali SM, Cheong KC, Kuay LK, Li LH, Ying CY, Huey TC, Yee LW, Ying OS, Yen YL, Abdullah N, Wymen S, Ibrahim N. Correlates of Susceptibility to Smoking among Secondary School Students in Kota Tinggi District, Johor, Malaysia. Asian Pac J Cancer Prev 2013; 14:6971-8. [DOI: 10.7314/apjcp.2013.14.11.6971] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ossip DJ, Chang Y, Nabi-Burza E, Drehmer J, Finch S, Hipple B, Rigotti NA, Klein JD, Winickoff JP. Strict smoke-free home policies among smoking parents in pediatric settings. Acad Pediatr 2013; 13:517-23. [PMID: 24238677 PMCID: PMC4046861 DOI: 10.1016/j.acap.2013.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 05/27/2013] [Accepted: 06/10/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine strict smoke-free home policies among smoking parents assessed in pediatric offices. METHODS We analyzed baseline parental survey data from 10 control practices in a national trial of pediatric office-based tobacco control interventions (Clinical Effort Against Secondhand Smoke Exposure, CEASE). We used logistic regression models with generalized estimating equations to examine factors associated with strict smoke-free home policies. RESULTS Subjects were 952 parents who were current smokers. Just over half (54.3%) reported strict smoke-free home policies. Few reported being asked (19.9%) or advised (17.1%) regarding policies by pediatricians. Factors associated with higher odds of policies were child 5 years or younger (adjusted odds ratio [aOR] 2.43, 95% confidence interval [CI] 1.53, 3.86), nonblack race/ethnicity (aORs 2.17-2.60, 95% CIs 1.25-5.00), non-Medicaid (HMO/private (aOR 1.84, 95% CI 1.31, 2.58); self-pay/other aOR 1.76, 95% CI 1.12, 2.78); well-child versus sick child visit (aOR 1.61, 95% CI 1.11, 2.34), fewer than 10 cigarettes per day (aOR 1.80, 95% CI 1.31, 2.47), no other home smokers (aOR 1.68, 95% CI 1.26, 2.25), only father smoking (aOR 1.73, 95% CI 1.06, 2.83), and strict smoke-free car policy (aOR 3.51, 95% CI 2.19, 5.64). CONCLUSIONS Nearly half of smoking parents did not have strict smoke-free home policies. Parents were less likely to report policies if they were heavier smokers, black, living with other smokers, or attending a sick child visit; if they did not have a young child or smoke-free car policy; if they had a child on Medicaid; and if anyone other than only the father smoked. Few pediatricians addressed or recommended strict smoke-free home policies in an office visit. The pediatric office encounter represents a currently missed opportunity to intervene regarding smoke-free homes, particularly for high-risk groups.
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Affiliation(s)
- Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY.
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Mahfouz MS, Alsanosy RM, Gaffar AM. The role of family background on adolescent khat chewing behavior in Jazan Region. Ann Gen Psychiatry 2013; 12:16. [PMID: 23688046 PMCID: PMC3679779 DOI: 10.1186/1744-859x-12-16] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 05/06/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Khat is a well-known natural stimulant from the Catha edulis plant and is widely used in certain Red Sea countries, including Yemen and the province of Jazan in Saudi Arabia. Jazan is located in the southwestern part of the Kingdom of Saudi Arabia adjacent to Yemen, where the practice of khat chewing is deeply rooted throughout the entire population. The main objective of this paper was to assess the association between family background, i.e., parent and sibling khat use, and adolescents' khat chewing behavior in Jazan. Other variables were also tested for association, including parents' education levels, family income, and peer influence. MATERIAL AND METHODS A cross-sectional study was conducted with a representative sample (n = 4,100) of intermediate and upper secondary school students of Jazan. The participants were selected using a three-stage cluster random sampling. A structured self-administered questionnaire was used for data collection. Descriptive statistics, a chi-squared test, and logistic regression were performed to examine the associations and predictors of khat chewing. RESULTS A total of 3,923 students of both genders from 72 intermediate and upper secondary schools in Jazan were involved in this study. Of these participants, 42.8% (1,678) were from intermediate schools and 43.8% (1,717) were females. The prevalence of current khat chewing among the students was 20.5% (95% confidence interval (CI) 19.27-21.79) and was significantly higher for males at 33.1% (95% CI 31.16-35.08) than for females, of whom 4.3% (95% CI 3.39-5.31) (P < 0.001) chew khat. The multivariate logistic regression analysis suggests that the most important independent predictors of student khat chewing included the students' smoking status (odds ratio (OR) = 14.03, P < 0.001), a friend using khat (OR = 5.65, P < 0.001), a sister using khat (OR = 2.04, P < 0.05), a father using khat (OR = 1.45, P < 0.001), and a brother using khat (OR = 1.56, P < 0.05). CONCLUSION The results highlight the significant impact of peer and familial khat abuse in adolescent khat chewing behavior. The findings suggest that khat control programs need to focus on peers and family members to reduce the prevalence of the habit along with its unfavorable consequences.
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Affiliation(s)
- Mohamed Salih Mahfouz
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, PO Box 2531, Jazan 45142, Saudi Arabia.
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Schultz ASH, Nowatzki J, Ronson G. Effects of household socialization on youth susceptibility to smoke: differences between youth age groups and trends over time. Am J Public Health 2013; 103:e39-42. [PMID: 23678907 DOI: 10.2105/ajph.2013.301344] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A Canadian biennial youth survey facilitated repeating investigation of susceptibility to smoke and household socialization. We operationalized susceptibility to smoke by 3 levels on the basis of intention and behavior. Variables consistently predicting greater susceptibility across time and age groups were sibling smoking, household restrictions, and vehicle smoke exposure. Gender was predictive among older youths. Household restrictions and emerging legislation to ban smoking in vehicles with youth passengers provide protection against secondhand smoke exposure and sustained resolve to remain smoke-free.
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Affiliation(s)
- Annette S H Schultz
- Faculty of Nursing, University of Manitoba and Psychosocial Oncology & Cancer Nursing Research Group, St. Boniface Research Centre, Winnipeg, Canada.
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Paulik E, Maróti-Nagy Á, Nagymajtényi L, Rogers T, Easterling D. The role of home smoking bans in limiting exposure to secondhand tobacco smoke in Hungary. HEALTH EDUCATION RESEARCH 2013; 28:130-140. [PMID: 22653684 PMCID: PMC3549583 DOI: 10.1093/her/cys057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Our objective was to assess how exposure to secondhand tobacco smoke occurs in Hungarian homes, particularly among non-smokers, and to examine the effectiveness of home smoking bans in eliminating exposure to secondhand smoke at home. In 2009, 2286 non-smokers and smokers aged 16-70 years, who were selected randomly from a nationally representative sample of 48 Hungarian settlements, completed paper-and-pencil self-administered questionnaires addressing tobacco-related attitudes, opinions and behaviors. Chi-square tests, one-way analysis of variance and multivariate logistic regression models were used to assess the effect of demographics, socio-economic characteristics and home smoking policies on the risk of exposure to secondhand tobacco smoke at home. Significantly higher risk of exposure was found among younger, lower educated and poorer people and among those having no or partial home smoking restrictions. There was a significant interaction between education level and home smoking policies: the effect of a smoking ban on exposure to secondhand tobacco smoke was stronger for the lower educated group than the higher educated group. The results suggest that Hungarians are making good progress in implementing home smoking bans, and that in the majority of population these bans are working. More can be done to promote the uptake of home smoking bans among poorer and less educated subpopulations.
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Affiliation(s)
- Edit Paulik
- Department of Public Health, Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary.
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Zhang X, Martinez-Donate AP, Kuo D, Jones NR. "How is smoking handled in your home?": agreement between parental reports on home smoking bans in the United States, 1995-2007. Nicotine Tob Res 2012; 14:1170-9. [PMID: 22377935 PMCID: PMC3457709 DOI: 10.1093/ntr/nts005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 01/09/2012] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Home smoking bans significantly reduce secondhand smoke exposure among children, but parents may offer discordant reports on whether there is a home smoking ban. The purpose of this study was to examine national trends in (a) parental discordance/concordance in the reporting of home smoking bans and (b) correlates of discordant/concordant reports among two-parent households with underage children from 1995 to 2007. METHODS Data from the 1995/1996, 1998/1999, 2001/2002, 2003, and 2006/2007 Tobacco Use Supplement of the U.S. Current Population Survey were used to estimate prevalence rates and multinomial logistic regression models of discordant/concordant parental smoking ban reports by survey period. RESULTS Overall, the percentage of households in which the 2 parents gave discordant reports on a complete home smoking ban decreased significantly from 12.7% to 2.8% from 1995 to 2007 (p < .001). Compared with households where both parents reported a complete smoking ban, discordant reports were more likely to be obtained from households with current smokers (p < .01) across survey periods. Compared with households where both parents reported the lack of a complete home smoking ban, discordant reports were more likely among households with college graduates, no current smokers, and parents with Hispanic ethnicity (p < .05). CONCLUSIONS Parental concordance on the existence of a home smoking ban increased from 1995 to 2007. This suggests estimates of home smoking bans based on just one parent may be more reliable now than they were in the past. Interventions to improve the adoption and enforcement of home smoking bans should target households with current smoker parents.
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Affiliation(s)
- Xiao Zhang
- Department of Population Health Sciences, University of Wisconsin–Madison, Madison, WI
| | - Ana P. Martinez-Donate
- Department of Population Health Sciences, University of Wisconsin–Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, WI
| | - Daphne Kuo
- Population Health Institute, University of Wisconsin–Madison, Madison, WI
| | - Nathan R. Jones
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, WI
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Hrubá D, Zaloudíková I. What limits the effectiveness of school-based anti-smoking programmes? Cent Eur J Public Health 2012; 20:18-23. [PMID: 22571011 DOI: 10.21101/cejph.a3722] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND It is generally accepted that living in families where there are smokers, children are stressed not only by the harmful physical exposure to second-hand and third-hand tobacco smoke, but also by the negative models of the adult relatives' behaviour, as relatives who smoke can inspire children to imitate this behaviour, influencing attitudes towards, and early experiments with smoking. In this paper, some of the most important results about influence of family smoking on the effects of the anti-smoking educational programme "Non-smoking Is Normal" are described. METHODS The school-based programme was created by medical and educational specialists and targets children at the first level of primary schools (aged from 6 to 11 years). The data about interesting outcomes of the programme (knowledge, attitudes, behaviour) were collected by anonymous questionnaire, administered twice in each school year: one month before the complex of 5 lectures (pre-tests) and 4-5 months after the last lecture (post-tests). The sample of participants (860-910) was divided into four groups, according to the intervention and family backrounds: (1) programme children from smoking families "P-S"; (2) control children from smoking families "C-S"; (3) programme children from non-smoking families "P-NS"; (4) control children from non-smoking families "C-NS". The differences in the frequency of children's answers were analysed using the tests in statistic Epi Info software, version 6.04a (chi-square, Mantel Haenszel, Yates, Fisher). RESULTS In the programme group, the number of children with smoking relatives was significantly higher than in the control group (80.1% vs. 73.0%, p < 0.01) as well as of those who reported frequent/daily exposure to secondhand smoke at homes and/or in cars (49.5% vs. 40.0%, p < 0.01). Smoking families significantly influenced the children's seeking of smoking friends (40% vs. 17%, p < 0.01). The programme has significantly increased the amount of knowledge about health risks of smoking. Both in the programme and control groups of children from non-smoking families, the frequency of critics of adults smoking was significantly higher all the time of the study (p < 0.05 and 0.01 resp.); however, the programme influenced children's opinions about smoking (criticism) only partially. Children's actual intentions about their smoking in the future was fully influenced by their smoking household environment: the number of "future no-smokers" has decreased in time and was significantly less frequent among children from smoking families (p < 0.01). The frequency of those willing to smoke significantly increased within the period between 3rd and 5th grades, both in the programme and the control groups (p < 0.01). An almost linear increase of active experimentations with cigarette smoking in follow-up monitoring was seen, trends of smoking children were steeper in groups from smoking families. The number of experiments with smoking was significantly lower in programme children of non-smoking parents only at the end of the study (p < 0.05). CONCLUSIONS Despite of the effort to initiate parental participation on the primary prevention of smoking, we have confirmed that smoking in families decreased the efficacy of anti-smoking intervention targeted on young children at school age.
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Goldade K, Choi K, Bernat DH, Klein EG, Okuyemi KS, Forster J. Multilevel predictors of smoking initiation among adolescents: findings from the Minnesota Adolescent Community Cohort (MACC) study. Prev Med 2012; 54:242-6. [PMID: 22245269 PMCID: PMC3319284 DOI: 10.1016/j.ypmed.2011.12.029] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 12/20/2011] [Accepted: 12/29/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To understand how factors at multiple levels of influence impact adolescent smoking initiation. METHOD Data from the Minnesota Adolescent Community Cohort, a population-based cohort, were analyzed. Adolescents were recruited from randomly selected geopolitical units (GPUs) in Minnesota at ages 12 to 13 (n=1953), and were surveyed every six months (2000-2006) until 18. The association between baseline social factors and smoking initiation was analyzed using logistic regression. Linear regression was used to analyze predictors and age of initiation among smokers (n=603). RESULTS Higher proportion of 15-16 year-olds who smoke at the area-level (GPU) was associated with younger initiation (15.47 vs 15.87, p<.05). Higher proportion of the population employed and higher median household income were associated with older initiation (15.90 vs. 15.56 p<.05). Parent education, living with parents or siblings who smoke, living in homes that allow smoking, and having friends who smoke at baseline were associated with smoking initiation or younger initiation (p<.05). Participants whose parents had less than a high school education were 1.6 times more likely than those with college educated parents to have smoked at least a whole cigarette (CI=1.06, 2.26). CONCLUSION Factors at multiple levels of influence effect adolescent smoking initiation. Smoking by older age peers and lower SES predicts earlier smoking.
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Affiliation(s)
- Kate Goldade
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St. SE, Suite 166, Minneapolis, MN 55414 USA, Ph. 612-625-5474 Fax. 612-626-6782
| | - Kelvin Choi
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 Second Street South, Suite 300, Minneapolis, MN 55454, USA
| | - Debra H. Bernat
- Department of Medical Humanities & Social Sciences, College of Medicine, Florida State University, 1115 West Call Street, P.O. Box 3064300, Tallahassee, FL 32306-4300 USA
| | - Elizabeth G. Klein
- Division of Health Behavior & Health Promotion, College of Public Health, Ohio State University, 174 W 18 Avenue, Columbus, OH 43210 USA
| | - Kolawole S. Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St SE, Minneapolis, MN 55414 USA
| | - Jean Forster
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S. Second St., Suite 300, Minneapolis, MN 55454 USA
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Vázquez-Rodríguez CF, Vázquez-Nava F, Vázquez-Rodríguez EM, Morales-Romero J, Iribar-Ibabe MC, Peinado-Herreros J. Smoking in Non-Student Mexican Adolescents With Asthma. Relation With Family Structure, Educational Level, Parental Approval of Smoking, Parents Who Smoke, and Smoking Friends. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.arbr.2011.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Tjora T, Hetland J, Aarø LE, Øverland S. Distal and proximal family predictors of adolescents' smoking initiation and development: a longitudinal latent curve model analysis. BMC Public Health 2011; 11:911. [PMID: 22152017 PMCID: PMC3297654 DOI: 10.1186/1471-2458-11-911] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 12/09/2011] [Indexed: 12/03/2022] Open
Abstract
Background Studies on adolescent smoking indicate that the smoking behaviours of their parents, siblings and friends are significant micro-level predictors. Parents' socioeconomic status (SES) is an important macro-level predictor. We examined the longitudinal relationships between these predictors and the initiation and development of adolescents' smoking behaviour in Norway. Methods We employed data from The Norwegian Longitudinal Health Behaviour Study (NLHB), in which participants were followed from the age of 13 to 30. We analysed data from the first 5 waves, covering the age span from 13 to 18, with latent curve modeling (LCM). Results Smoking rates increased from 3% to 31% from age 13 to age 18. Participants' smoking was strongly associated with their best friends' smoking. Parental SES, parents' smoking and older siblings' smoking predicted adolescents' initial level of smoking. Furthermore, the same variables predicted the development of smoking behaviour from age 13 to 18. Parents' and siblings' smoking behaviours acted as mediators of parents' SES on the smoking habits of adolescents. Conclusions Parents' SES was significantly associated, directly and indirectly, with both smoking initiation and development. Parental and older siblings' smoking behaviours were positively associated with both initiation and development of smoking behaviour in adolescents. There were no significant gender differences in these associations.
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Affiliation(s)
- Tore Tjora
- Uni Health, Uni Research, Christiesgate 12, 5015 Bergen, Norway.
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Home smoking bans among U.S. households with children and smokers. Opportunities for intervention. Am J Prev Med 2011; 41:559-65. [PMID: 22099231 DOI: 10.1016/j.amepre.2011.08.016] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 07/01/2011] [Accepted: 08/05/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND Public health campaigns have reduced the exposure of U.S. children to secondhand smoke at home; however, these may not have been equally effective across subgroups. PURPOSE To examine prevalence of home smoking bans among U.S. households with both children and smokers, over time and by demographic subgroups. METHODS The Tobacco Use Supplement to the Current Population Survey (TUS-CPS) is a nationally representative household survey of tobacco use. The 1992/1993 and 2006/2007 TUS-CPS interviewed 22,746 households from a major racial/ethnic group with both children and adult smokers. Predictors of complete home smoking bans among demographic subgroups were identified using multivariate logistic regression. Analyses were conducted in 2010-2011. RESULTS Complete home smoking bans among U.S. households with children and smokers (smoking families) more than tripled, from 14.1% in 1992/1993 to 50.0% in 2006/2007. However, non-Hispanic white and African-American smoking families lagged behind Asian/Pacific Islanders and Hispanics. In 2006/2007, 67.2% of African-American smoking families allowed smoking in the home, as did 59.2% of smoking families with all children aged ≥14 years. Bans were more likely among more-educated households and in states with lower adult smoking prevalence; however, these differences were attenuated in some racial/ethnic groups. CONCLUSIONS As of 2006/2007, only half of U.S. households with both children and smokers had complete home smoking bans. Home bans were less common among smoking families with older children, in African-American households, and in Hispanic or non-Hispanic white households in states with high smoking prevalence. Interventions are needed to promote smoke-free homes among these groups.
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Temple B, Johnson J. Provision of smoke-free homes and vehicles for kindergarten children: associated factors. J Pediatr Nurs 2011; 26:e69-78. [PMID: 22055386 DOI: 10.1016/j.pedn.2011.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 12/31/2010] [Accepted: 01/06/2011] [Indexed: 11/16/2022]
Abstract
Many children continue to be exposed to environmental tobacco smoke (ETS) each day. To describe the factors associated with providing a smoke-free home (PSFH) and vehicle (PSFV) for kindergarten children, a cross-sectional descriptive study was conducted in Manitoba, Canada, with 551 mothers and primary caregivers responding. A social-ecologic model of health behavior guided the study. In the bivariate analysis, being better educated, living with a partner, and having a higher income were associated with PSFH. In the multivariable logistic regression analysis, the variables most predictive for PSFH were living with a partner and the mother's self-efficacy, and for PSFV, the most predictive variables were the mother's self-efficacy and ETS knowledge. Smoking behaviors are complex and must be considered broadly within all levels of influence if nurses are to assist parents in protecting their children.
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Affiliation(s)
- Beverley Temple
- Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.
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